Choice of the method of endoscopic resection of subepithelial gastric tumors

Introduction. The introduction of endoscopic intraluminal technologies is one of the current trends in the surgical treatment of patients with gastric subepithelial lesions. The number of publications showing the success of endoscopic operations is growing. Despite this and due to the variable characteristics of these tumors, there is no single algorithm for choosing a technique. Aim. To improve the results of treatment of patients with subepithelial lesions of the stomach.Materials and methods. We retrospectively analysed 74 patients with subepithelial lesions who underwent different endoscopic surgeries in our hospital from 2013 to 2022. 27 patients underwent endoscopic dissections in the submucosal layer, 34 tunnel dissections, 10 endoscopic muscle dissections and 3 full-thickness resections.Results. All surgical interventions were performed as planned. No intra- and postoperative complications requiring changes in therapeutic setting occurred. Carboxyperitoneum was detected in 17 patients (50%) who underwent tunnel intervention. Only 8 cases (23,5%) required decompression of the abdominal cavity using a Veress needle. Upper GI endoscopy and CT of the chest and abdominal cavity were performed at 6 and 12 months. No recurrence was observed.Conclusion. The developed algorithm for choosing a technique of gastric subepithelial lesions endoscopic removal allows to gain the correct access to the tumor. As a result of the operation can be performed with minimal time costs and risks of complications. Rapid rehabilitation is an undoubted advantage of endoscopic interventions.